Orthotics
ASK THE PODIATRIST
ORTHOTIC DEVICES
--Dr. Jay C. Goldstein
Q. I have been told that I need orthotics. What exactly are they, and will they help?
A. Orthoses (often referred to as orthotics) are medical devices that are used to improve body support, function, and/or alignment. Foot orthoses (orthotics) would do so for feet. Most of the time, patients would get one for each foot, otherwise they would be unbalanced. If lost in a forest, they might never make their way out.
ARE ORTHOTIC DEVICES HELPFUL FOR EVERYONE?
Are eyeglasses helpful for everyone? Neither are orthotic devices. On the other hand, many people with less than perfect vision are grateful for their glasses. Many people with less than perfect foot and leg structure would benefit from foot orthotics.
HOW ARE ORTHOTICS MADE
Custom orthotic devices are made from cast impressions of feet while held in the desired position. If you simply step into plaster, you will get an impression of your foot the way it is now; why would you want a device to hold your foot in its current position?
The cast impressions are combined with measurements of the feet and legs. Most podiatrists send the cast impressions and the prescription to a lab to make at least part of the orthotic devices since the equipment required is very expensive.
There are outlets that make devices from pre-made forms that come in different sizes and may or may not be heated. In my opinion, it is unethical to charge a patient and represent this process as if they are getting a true custom device.
WHO NEEDS CUSTOM ORTHOTIC DEVICES?
Not everyone.
If one has less than perfect foot and/or leg structure that is causing a deformity and/or symptoms, foot orthotics may be indicated. Such conditions would include someone whose foot rolls in or out too much; someone whose bones shift significantly while walking/running; someone whose muscles, tendons, and/or ligaments get strained during function; and someone who suffers from excess torque on a joint when walking/running.
FINALLY
Foot orthotics may be very helpful for appropriate problems. They are not a be-all and end-all. They may need to be adjusted until symptoms are alleviated, which may require patience on the part of the doctor and the patient. All other factors that are contributing to the problem (weight, activities, injured tissues, shoes, etc.) should be identified and dealt with. For some problems, other forms of treatment may also be needed.
Dr. Goldstein is Board Certified in Podiatric Surgery, Podiatric Orthopedics, and in Podiatric Medicine. He has been running for more years than he has not been running, but has not done triathlons for as long as he has been running. He does not wear his orthotic devices when swimming. When not running or resting, he can be found at his Podiatry office in Portland, Oregon.